Evaluation of cognitive functions in systemic lupus erythematosus patients and examination of the relationship between cognitive functions, autoantibodies and brain imaging findings

This study aimed to evaluate neuropsychiatric systemic lupus erythematosus (NPSLE) patients regarding cognitive functions and the relationship between cognitive functions and autoantibodies, brain imaging findings. 24 NPSLE patients and 12 healthy controls were included in the study. Patients and controls were evaluated with the Structured Clinical Interview for DSM-5® (SCID-5), and both groups were given a cognitive test battery, volumetric magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI) were applied. In the patient group, blood sample was taken for anti-ribosomal P protein. Voxel-based morphometry was used for volumetric MRI, and the Tract-Based Spatial Statistics (TBSS) method was used for DTI. As a result of the SCID-5 application, all patients were diagnosed with depression. It was shown that there were significant impairments in many cognitive areas in the NPSLE group, especially attention, language skills, executive functions, and visual-spatial skills. In the patient group, right subgenual anterior cingulate cortex (sACC) and cerebellum volumes was lower than healthy control. Compared the healthy controls, the right external capsule fractional anisotropy was lower in the patient groups. It was shown that there were negative correlations between anti-ribosomal P protein and anti-ds DNA levels and working memory, attention, and executive functions. Correlations were detected between cognitive test results evaluating short-term memory, working memory, attention, information processing capacity, and executive functions and volumetric MRI and DTI findings. Our study showed that volume loss in the right sACC and cerebellum and deterioration in white matter integrity in the right external capsule accompanied cognitive dysfunction in NPSLE and that the deterioration in cognitive functions is associated with autoantibody levels.